Nishiyama M, Takashima I, Tanaka T, Yoshida K, Toge T, Nagata N, Iwamori S, Tamura Y
Department of Surgery, Research Institute for Nuclear Medicine and Biology, Hiroshima University, Japan.
World J Surg. 1995 Jan-Feb;19(1):133-7; discussion 137. doi: 10.1007/BF00316997.
At the time of laparotomy, peritoneal washings were collected from 155 gastric cancer patients and the levels of carcinoembryonic antigen (CEA) determined. The CEA levels in peritoneal washings were statistically independent of those in sera and could more reliably predict the presence of peritoneal metastasis than a cytologic study. Peritoneal recurrence was seen in 14 of 118 patients after curative operation. Of the 14 patients, 10 (71%) had elevated levels of CEA (100 ng/g protein) at surgery. Of these 10 cases, 2 of the tumors were classified as stage IB and 4 had no serosal invasion. Only one patient with peritoneal metastasis and a low CEA level was free from relapse more than 1 year after operation. Kaplan-Meier's analysis showed that a high CEA level in peritoneal washings was a predictor of poor prognosis in patients who underwent either curative or noncurative resection. A proportional hazards regression analysis showed that a high CEA level in peritoneal washings was statistically significant in terms of predicting a shorter interval until peritoneal recurrence (p = 0.0002) and for survival (p = 0.0001). The CEA level in peritoneal washings is therefore of value as an indicator of peritoneal recurrence and prognosis.
在剖腹手术时，收集了155例胃癌患者的腹腔冲洗液，并测定了癌胚抗原（CEA）水平。腹腔冲洗液中的CEA水平与血清中的CEA水平在统计学上无关，并且比细胞学检查更能可靠地预测腹膜转移的存在。118例患者在根治性手术后出现了14例腹膜复发。在这14例患者中，10例（71%）在手术时CEA水平升高（>100 ng/g蛋白质）。在这10例病例中，2例肿瘤被分类为IB期，4例没有浆膜侵犯。只有1例腹膜转移且CEA水平低的患者在术后1年多没有复发。Kaplan-Meier分析表明，腹腔冲洗液中CEA水平高是接受根治性或非根治性切除患者预后不良的预测指标。比例风险回归分析表明，腹腔冲洗液中CEA水平高在预测腹膜复发的较短间隔时间（p = 0.0002）和生存（p = 0.0001）方面具有统计学意义。因此，腹腔冲洗液中的CEA水平作为腹膜复发和预后的指标具有价值。
